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South Carolina rates for HCPCS Q5121

Injection, infliximab-axxq, biosimilar, (AVSOLA), 10 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.64 / $32.65 / $6,825.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.08 / $32.34 / $39.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$41.21 / $63.00 / $109.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $21.65 / $51.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.05 / $20.41 / $20.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.41 / $20.41 / $20.41
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.64 / $39.17 / $60.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.28 / $79.28 / $79.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.68 / $34.68 / $38.15